J Korean Soc Radiol.  2015 Sep;73(3):147-157. 10.3348/jksr.2015.73.3.147.

Quantitative CT Assessment in Chronic Obstructive Pulmonary Disease Patients: Comparison of the Patients with and without Consistent Clinical Symptoms and Pulmonary Function Results

• Nam B
• Hwang JH
• Lee YM
• Park JS
• Jou SS
• Kim Y

• KMID: 2043604
• DOI: http://doi.org/10.3348/jksr.2015.73.3.147

Abstract

PURPOSE
We compared the clinical and quantitative CT measurement parameters between chronic obstructive pulmonary disease (COPD) patients with and without consistent clinical symptoms and pulmonary function results.
MATERIALS AND METHODS
This study included 60 patients having a clinical diagnosis of COPD, who underwent chest CT scan and pulmonary function tests. These 60 patients were classified into typical and atypical groups, which were further sub-classified into 4 groups, based on their dyspnea score and the result of pulmonary function tests [typical 1: mild dyspnea and pulmonary function impairment (PFI); typical 2: severe dyspnea and PFI; atypical 1: mild dyspnea and severe PFI; atypical 2: severe dyspnea and mild PFI]. Quantitative measurements of the CT data for emphysema, bronchial wall thickness and air-trapping were performed using software analysis. Comparative statistical analysis was performed between the groups.
RESULTS
The CT emphysema index correlated well with the results of the pulmonary functional test (typical 1 vs. atypical 1, p = 0.032), and the bronchial wall area ratio correlated with the dyspnea score (typical 1 vs. atypical 2, p = 0.033). CT air-trapping index also correlated with the results of the pulmonary function test (typical 1 vs. atypical 1, p = 0.012) and dyspnea score (typical 1 vs. atypical 2, p = 0.000), and was found to be the most significant parameter between the typical and atypical groups.
CONCLUSION
Quantitative CT measurements for emphysema and airways correlated well with the dyspnea score and pulmonary function results in patients with COPD. Air-trapping was the most significant parameter between the typical vs. atypical group of COPD patients.

MeSH Terms

Diagnosis
Dyspnea
Emphysema
Humans
Pulmonary Disease, Chronic Obstructive*
Respiratory Function Tests
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Findings of emphysema and color maps. Axial CT images (A, C) show diffuse centriacinar emphysema with low attenuation areas in both lungs. Color map images (B, D) show blue colored areas corresponding to emphysema lung (below -950 HU) and yellow colored areas corresponding to normal lung (above -900 HU). HU = Hounsfield units

• 

  Fig. 2 Measurement of airway and schematic diagram. A. Short-axis image of the bronchus obtained from the curved multi-planar reformation is precisely perpendicular to the long-axis of the airway B. The schematic diagram of short-axis image of the bronchus shows the airway wall area (Ao), airway luminal area (Ai), outer diameter (Dmax), and inner diameter (Dmin).

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